Provider Demographics
NPI:1487833836
Name:MARGO J. WILLIAMS
Entity Type:Organization
Organization Name:MARGO J. WILLIAMS
Other - Org Name:ORTHOCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CO, LO
Authorized Official - Phone:469-371-2686
Mailing Address - Street 1:PO BOX 112056
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-2056
Mailing Address - Country:US
Mailing Address - Phone:469-371-2686
Mailing Address - Fax:972-242-4253
Practice Address - Street 1:2680 DENTON TAP RD STE 103
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8211
Practice Address - Country:US
Practice Address - Phone:469-371-2686
Practice Address - Fax:972-242-4253
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARGO J. WILLIAMS ORTHOCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX158335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5285350001Medicare NSC